In July, the Kaiser Family Foundation released an analysis of Medicare spending that illustrated a significant slowdown in Medicare payments to healthcare providers and plans. The planned reduction in spending through the Affordable Care Act (ACA) and other cutbacks such as the competitive bidding program were greater than expected, showing that in the year 2014, Medicare spent $1,000 less per person than projected in the early stages of the ACA. The Kaiser analysis showed the trend is expected to continue this way, predicting a per-person decrease in spending of $2,400 by the year 2019.

The reality of Medicare cutbacks is not new to us in the complex rehab technology (CRT) field. But the Kaiser projections demonstrating cuts that were more drastic than expected suggest how important it is to adjust business models for efficiency and to thrive in changing times.

To stay in the game, healthcare providers are reacting to the policy changes by arming themselves with the tools to prove their efficacy. Whether being forced by government requirements as part of an accountable care organization or choosing to make a savvy business decision to remain competitive, hospitals, physicians and some medical equipment providers are learning to speak the language of outcomes. Now is the time for CRT providers to adopt outcomes measurement as a fundamental new strategy to fully participate in the new value-based health care paradigm.

What Is Outcomes Measurement?

Outcomes measurement is the collection of reliable, clinically meaningful, evidence-based data that measures functional change and consumer or caregiver satisfaction as it relates to quality-of-life issues. The collection of data is consistent, comprehensive and is based on metrics created by clinical experts.

The data, which is collected by means of consumer-centered surveys over a period of several months, helps business owners better understand the costs and benefits of providing quality care with high levels of consumer satisfaction.

So why does outcomes measurement matter?

The healthcare system as a whole is shifting business models to reflect outcomes-driven decision making, but as of now, no government entities are requiring medical equipment providers to participate. Measuring outcomes is a valuable proposition for your business, and here’s why.

• CRT providers must stay relevant during the outcomes-driven strategy shift. Throughout the healthcare system, the government is requiring evidence-based outcomes data to participate in accountable care organizations. The government and other healthcare entities are speaking a new language. By implementing outcomes measurement, CRT providers maintain clinical relevancy and have evidence to prove value to policymakers when funding or access to CRT are on the chopping block. Now is the time to persuade decision makers to include DME in the larger health dataset.
• Today’s healthcare market expects measurable outcomes. CRT providers that demonstrate consumer outcomes will gain a competitive advantage over those who choose to work under the status quo. Presenting outcomes data to physical therapists, hospital discharge planners and health system decision-makers will aid your communications and marketing, making your business a more attractive partner. Information related to rehabilitation, recovery, aging, disability and ongoing quality-of-life issues are all included in the measurements.
• Consumer-driven outcomes build relationships and show value to customers. Providers can position their businesses as patient-care experts by clearly defining the clinical delivery process and strategy to reducing readmissions and co-morbidities for better customer satisfaction. Outcomes measurements are consumer-driven. Providers demonstrate superior care with an emphasis on proven results using a systematic approach. In addition, by monitoring consumer outcomes, providers can suggest future products and services to avoid adverse conditions.
• Outcomes knowledge allow for implementation of improvement plans starting from any level. Collecting outcomes data allows managers to analyze and compare datasets to identify problem areas and propose solutions. With guidance from experts, providers can implement a variety of solutions and over time form best practices that are evidence-based.

Capturing & Applying the Right Data

While outcomes measurement can be valuable to providers in many ways, figuring out which data is important, and then how to capture it — especially in the midst of everything else an ATP and a billing specialist has to do in a day — can be challenging. One way to approach that sizable task: Find a good partner.

For instance, VGM and U.S. Rehab have partnered with the University of Pittsburgh to use the Functional Mobility Assessment (FMA) developed by Mark Schmeler, Ph.D., OTR/L, ATP, an expert in seating & wheeled mobility, and functional outcomes measures and evidence-based practice.

The FMA collects basic consumer demographic information and requires the consumer to answer 10 questions ranging from daily functional needs to comfort and mobility. Twenty-one days after the initial service date, the questions are asked again to gauge functional ability, presence of co-morbidities and independence. The tool can be used continuously until a timeline determined together by provider and our outcomes team is met.

The results are measurable by organization, by professional (ATP), or by individual consumer to assist in recognizing patterns of problems or success. Results will also be broken into product categories to better understand the outcomes of providing one product versus another.

For comprehensive tracking of patient progress in a broader set of disease states, we are partnering with HealthCall to use PersonalTouch, a Web-based tool that will assist providers in managing patient population data and tracking patient progress as it relates to readmission. Through HealthCall, disease states that have been designated as CMS’s top readmissions diagnoses are tracked using automated routine interactions. The dataset gathered from HealthCall can be adapted to providers based on their diverse goals and risk-adjustment strategies. The information is transferred to and managed by our VGM Outcomes program, and distributed once established benchmarks are reached. In the future, we envision the coordination of both tools — FMA and PersonalTouch — to address the unique business needs of providers.

Using outcomes measurement, providers can improve efficiency and enter marketing and policy discussions from a position of strength. We all know that healthy consumers are happy consumers. When measuring outcomes, all parties, including patients, providers and the healthcare system, benefit. Being able to identify and quantify outcomes can not only improve the quality of care delivered, but will provide evidence-based data for the new value-based world of healthcare.